title: Does broad-spectrum beta-lactam resistance due to NDM-1 herald the end of the antibiotic era for treatment of infections caused by Gram-negative bacteria?
abstract: The NDM-1 gene, first identified in Sweden in 2008 in Klebsiella pneumoniae from a patient hospitalized in New Delhi, encodes a metallo-β-lactamase that inactivates all β-lactams except aztreonam. This bla(NDM-1) gene has been identified in hospital-acquired bacterial species, such as K. pneumoniae, but also in the typical community-acquired species, Escherichia coli. This gene has been identified in strains that possess other resistance mechanisms contributing to their multidrug resistance patterns. It has been recently extensively reported from the UK, India and Pakistan and, albeit to a lesser extent, from a number of other countries worldwide. In most of the cases a link with the Indian subcontinent has also been established. To stem the onslaught of NDM producers, early identification of cases of NDM-related infections and prevention of their spread by implementing screening, hygiene measures and the isolation of carriers is needed.
authors.affiliation: Service de Bactériologie-Virologie, INSERM U914 Emerging Resistance to Antibiotics, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine et Université Paris-Sud, K.-Bicêtre, France. nordmann.patrice@bct.aphp.fr
authors.forename: Patrice
authors.initials: P
authors.lastname: Nordmann
authors.forename: Laurent
authors.initials: L
authors.lastname: Poirel
authors.forename: Mark A
authors.initials: MA
authors.lastname: Toleman
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Walsh
mesh_terms: D021821:Communicable Diseases, Emerging / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007194:India / Q000453:epidemiology; D017053:Infection Control / Q000379:methods; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification; D008403:Mass Screening / Q000379:methods; D010154:Pakistan / Q000453:epidemiology; D058873:Pandemics; D013548:Sweden / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis*; D047090:beta-Lactams / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D047090:beta-Lactams; D001618:beta-Lactamases; C552864:beta-lactamase NDM-1